| NPI | 1013956218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35050025) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.050025) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2014-08-08 |