| NPI | 1114269222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.127134) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OH 35.127134) |
| Enumeration Date | 2013-03-27 |
| Last Update Date | 2021-07-20 |