| NPI | 1407275415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CO DR.0067013) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.131954) |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2021-10-29 |