| 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 |