| NPI | 1578785903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35-092633) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35-092633) |
| 208M00000X Hospitalist (Licence: OH 35-092633) | |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2013-05-01 |