| NPI | 1578561361 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: VA 0102205117) | 
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OH 34.007711) | 
| Enumeration Date | 2005-07-14 | 
| Last Update Date | 2020-10-09 |