| NPI | 1952519142 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 52291) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57-011008) |
| 207R00000X Internal Medicine (Licence: WI 52291) | |
| Enumeration Date | 2007-05-19 |
| Last Update Date | 2024-05-31 |