| NPI | 1033315965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 53839) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036117862) |
| 207RN0300X Internal Medicine, Nephrology (Licence: NV 19123) | |
| 208M00000X Hospitalist (Licence: MO 2011011351) | |
| 208M00000X Hospitalist (Licence: IL 036117862) | |
| 208000000X Pediatrics (Licence: IL 036117862) | |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2025-09-23 |