| NPI | 1689652372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.051279) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OH 35-051279) |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2013-11-25 |