| NPI | 1689669053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 34-006478) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 34006478) |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2015-07-13 |