| NPI | 1821271677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AK 6939) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: OH 57-013321) |
| Enumeration Date | 2007-12-14 |
| Last Update Date | 2015-10-27 |