| NPI | 1568951689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.142932) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OH 35.142932) |
| Enumeration Date | 2018-05-03 |
| Last Update Date | 2021-08-27 |