| NPI | 1154634798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35.121926) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 57.017641) |
| Enumeration Date | 2010-07-25 |
| Last Update Date | 2018-05-18 |