| NPI | 1740220854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.053772) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OH 35.053772) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2026-02-05 |