| NPI | 1821235540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35.094890) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 094890) |
| 207R00000X Internal Medicine (Licence: OH 35.094890) | |
| Enumeration Date | 2009-01-16 |
| Last Update Date | 2019-12-05 |