| NPI | 1063495620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35.083952) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35-08-3952) |
| Enumeration Date | 2005-11-28 |
| Last Update Date | 2011-03-16 |