| NPI | 1477503449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: GA 068505) |
| Additional Taxonomies | 2085R0001X (Licence: FL ME96250) |
| 2085R0001X (Licence: OH 35047778) | |
| 208M00000X Hospitalist (Licence: GA 068505) | |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2017-10-05 |