| NPI | 1760463376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 058894) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35085875) |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2021-08-17 |