| NPI | 1225612971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35.149365) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.149365) |
| Enumeration Date | 2021-05-10 |
| Last Update Date | 2024-06-06 |