| NPI | 1629201827 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.094693) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MI 4301088529) |
| Enumeration Date | 2009-09-03 |
| Last Update Date | 2012-04-06 |