| NPI | 1700272804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX T2498) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.133914) |
| 208M00000X Hospitalist (Licence: OH 35.133914) | |
| Enumeration Date | 2015-04-15 |
| Last Update Date | 2021-10-31 |