| NPI | 1871540039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35084295) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MI 4301091575) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2015-07-29 |