| NPI | 1609175496 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 098916) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OH 35-098916) |
| Enumeration Date | 2011-03-20 |
| Last Update Date | 2022-07-21 |