| NPI | 1134701022 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35.150913) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.150913) |
| Enumeration Date | 2021-04-21 |
| Last Update Date | 2024-05-03 |