| NPI | 1801280953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: NE 1614) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 34016727) |
| 208M00000X Hospitalist (Licence: OH 34016727) | |
| Enumeration Date | 2015-03-26 |
| Last Update Date | 2024-02-19 |