| NPI | 1114334398 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA C193277) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.133268) |
| 208D00000X General Practice (Licence: OH 35.133268) | |
| 208M00000X Hospitalist (Licence: OH 35.133268) | |
| Enumeration Date | 2014-07-19 |
| Last Update Date | 2024-10-03 |