| NPI | 1306967286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: VA 0101243480) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.009152) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2017-04-12 |