| NPI | 1134190242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: OH 35054527) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35054527) |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2015-08-28 |