| NPI | 1609889989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC 31832) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OH 35087612) |
| 207R00000X Internal Medicine (Licence: OH 35087612) | |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2011-09-27 |