| NPI | 1689679953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 72767) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 34-00-7447) |
| Enumeration Date | 2005-06-14 |
| Last Update Date | 2020-10-12 |