| NPI | 1548395940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35.091398) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207Q00000X Family Medicine (Licence: OH 35.091398) | |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2014-06-30 |