| NPI | 1215432604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.141384) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.141384) |
| 208000000X Pediatrics (Licence: OH 57246387) | |
| 208M00000X Hospitalist (Licence: OH 35.141384) | |
| Enumeration Date | 2018-03-27 |
| Last Update Date | 2022-05-18 |