| NPI | 1194724369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RS0010X Internal Medicine, Sports Medicine (Licence: OH 35-080595) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35-080595) |
| 208M00000X Hospitalist (Licence: OH 35-080595) | |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2015-10-21 |