| NPI | 1023564176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX U6429) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX U6429) |
| 208M00000X Hospitalist (Licence: IL 036148311) | |
| Enumeration Date | 2016-08-29 |
| Last Update Date | 2024-09-25 |