| NPI | 1265896658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35139444) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35139444) |
| 208000000X Pediatrics (Licence: OH 35139444) | |
| Enumeration Date | 2016-04-12 |
| Last Update Date | 2020-09-22 |