| NPI | 1194863563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35.120063) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036-113985) |
| 207R00000X Internal Medicine (Licence: OH 35-120063) | |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: OH 35-120063) | |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2021-03-22 |