| NPI | 1306145990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35.122678) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.122678) |
| 207R00000X Internal Medicine (Licence: MI 4301108177) | |
| 207R00000X Internal Medicine (Licence: CO CDR.0003600) | |
| 208D00000X General Practice (Licence: OH 35.122678) | |
| 208M00000X Hospitalist (Licence: GA 99497) | |
| Enumeration Date | 2011-03-22 |
| Last Update Date | 2024-06-19 |