| NPI | 1861610875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.089937) |
| Additional Taxonomies | 261QS1000X Clinic/Center, Student Health (Licence: OH 57-008756) |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: OH 35.089937) | |
| 208M00000X Hospitalist (Licence: OH 35.089937) | |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2013-03-13 |