| NPI | 1790968543 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.094739) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OH 35.094739) |
| Enumeration Date | 2007-12-14 |
| Last Update Date | 2010-07-07 |