| NPI | 1528445756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35.135925) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.135925) |
| 208000000X Pediatrics (Licence: OH 35.135925) | |
| Enumeration Date | 2015-04-27 |
| Last Update Date | 2021-06-24 |