| NPI | 1366603516 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 099065) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301092681) |
| 208000000X Pediatrics (Licence: MI 4301092681) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301092681) | |
| Enumeration Date | 2008-06-20 |
| Last Update Date | 2021-11-01 |