| NPI | 1821246125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35095763) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.095763) |
| Enumeration Date | 2008-08-29 |
| Last Update Date | 2023-05-05 |