| NPI | 1104867795 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35-082208) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OH 35.082208) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2015-01-27 |