| NPI | 1972899219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 34010203) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OH 34.10203) |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2021-12-17 |