| NPI | 1528362258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 55649-20) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35122847) |
| Enumeration Date | 2011-01-10 |
| Last Update Date | 2016-09-26 |