| NPI | 1578817383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 073992) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 073992) |
| 207R00000X Internal Medicine (Licence: OH 57-022038) | |
| Enumeration Date | 2012-10-31 |
| Last Update Date | 2019-09-30 |