| NPI | 1720214497 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35.098411) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35098411) | 
| Enumeration Date | 2009-06-08 | 
| Last Update Date | 2019-02-22 |