| NPI | 1871840108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 50864) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.020796) |
| 207R00000X Internal Medicine (Licence: AZ 50864) | |
| Enumeration Date | 2012-08-06 |
| Last Update Date | 2015-10-06 |