| NPI | 1225569544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35.141715) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.141715) |
| 208100000X Physical Medicine & Rehabilitation (Licence: MN 64348) | |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2022-02-11 |