| NPI | 1942636170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MD D89504) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57022716) |
| 208M00000X Hospitalist (Licence: MO 2016023725) | |
| Enumeration Date | 2013-09-19 |
| Last Update Date | 2024-03-30 |