| NPI | 1780741058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35.053512) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35053512) |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2023-05-04 |