| NPI | 1588657670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35055617) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OH 35.055617) |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2020-01-07 |