| NPI | 1902883648 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35080113S) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OH 35-080113) |
| Enumeration Date | 2005-12-23 |
| Last Update Date | 2010-03-24 |