| NPI | 1871721696 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 81640)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35-099233)  | 
| 208M00000X Hospitalist (Licence: WI 81640)  | |
| Enumeration Date | 2009-07-01 | 
| Last Update Date | 2024-09-04 |