| NPI | 1104110337 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35.122762) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.122762) |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2014-10-08 |