| NPI | 1255861027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35.142365) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A157173) |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2021-07-27 |