| NPI | 1164630208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 57010063) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OH 35-090441) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2009-05-19 |