| NPI | 1558741116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35.133597) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 263984) |
| 207R00000X Internal Medicine (Licence: OH 35.133597) | |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2020-09-22 |