| NPI | 1609164136 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 080617) | 
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OH 35. 126068) | 
| Enumeration Date | 2011-07-18 | 
| Last Update Date | 2018-06-21 |