| NPI | 1194720599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35-081916) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35-081916) |
| Enumeration Date | 2005-06-14 |
| Last Update Date | 2017-08-10 |