| NPI | 1972542512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MS 17075) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OH 35-067153) |
| 208M00000X Hospitalist (Licence: LA 703) | |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2018-03-17 |