| NPI | 1275828857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 34.010973) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 34.010973) |
| 2083A0300X Preventive Medicine, Addiction Medicine (Licence: OH 34.010973) | |
| Enumeration Date | 2011-06-13 |
| Last Update Date | 2025-06-13 |