| NPI | 1871717561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35.091552) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH AO5603724-608-1705) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2015-10-13 |