| NPI | 1235115809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 34007200) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 34007200) |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2013-09-05 |