| NPI | 1730491960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 69331) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 29879) |
| 207R00000X Internal Medicine (Licence: OH 35.130209) | |
| Enumeration Date | 2010-07-02 |
| Last Update Date | 2024-01-26 |