| NPI | 1902211808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2017013099) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2017013099) |
| 207R00000X Internal Medicine (Licence: OH AP2282058A) | |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2022-07-21 |