| NPI | 1720231897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: OH 35.096316) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OH 35.096316) |
| 207R00000X Internal Medicine (Licence: OH 35.096316) | |
| Enumeration Date | 2008-11-03 |
| Last Update Date | 2025-08-21 |