| NPI | 1336353929 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MI 4301092403) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WV 22796) |
| 207R00000X Internal Medicine (Licence: OH 35.094429) | |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2010-09-26 |