| NPI | 1619255882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 069417) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.097586) |
| Enumeration Date | 2011-07-22 |
| Last Update Date | 2019-10-03 |