| NPI | 1114014057 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35-067010) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35-067010) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2013-09-11 |