| NPI | 1104183649 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 34011598) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OH 34.011598) |
| Enumeration Date | 2012-04-23 |
| Last Update Date | 2023-06-01 |