| NPI | 1063667889 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2013-01752) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2013-01752) |
| 208600000X Surgery (Licence: OH 57.015338) | |
| Enumeration Date | 2008-11-20 |
| Last Update Date | 2023-08-02 |