| NPI | 1952594129 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 35.095305) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.095305) |
| 208000000X Pediatrics (Licence: OH 35095305) | |
| Enumeration Date | 2007-08-21 |
| Last Update Date | 2024-02-28 |