| NPI | 1508911694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35-090297) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MI 4301084120) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2012-01-11 |