| NPI | 1972701217 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MN 55013) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OH 35090323) |
| 207R00000X Internal Medicine (Licence: OH 35090323) | |
| Enumeration Date | 2007-07-09 |
| Last Update Date | 2015-10-30 |