| NPI | 1538143011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 34.007954) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 34-00-7954) |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2011-03-16 |