| NPI | 1205857257 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34-00-4839) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OH 34004839) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2020-11-23 |