| NPI | 1740496553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35.089395) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.089395) |
| 207R00000X Internal Medicine (Licence: OH 35.089395) | |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2019-02-22 |