| NPI | 1619976669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35-081219) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35-081219) |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2012-02-07 |