| NPI | 1962829119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OH 34012860) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 34.012860) |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2022-11-30 |