| NPI | 1104809771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35.083168) |
| Additional Taxonomies | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: OH 35.083168) |
| 207R00000X Internal Medicine (Licence: OH 35.083168) | |
| Enumeration Date | 2005-11-28 |
| Last Update Date | 2015-06-01 |