| NPI | 1619953296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 34-00-8499) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OH 34.008499) |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2013-08-21 |