| NPI | 1205076569 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35.095717) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.095717) |
| 207Q00000X Family Medicine (Licence: CA C195632) | |
| Enumeration Date | 2009-02-26 |
| Last Update Date | 2024-05-22 |