| NPI | 1063670362 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 66902) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036-131668) |
| 207R00000X Internal Medicine (Licence: MO 2024043571) | |
| 208M00000X Hospitalist (Licence: MA 257524) | |
| 208M00000X Hospitalist (Licence: IL 036131668) | |
| 208M00000X Hospitalist (Licence: MO 2024043571) | |
| Enumeration Date | 2008-05-23 |
| Last Update Date | 2025-06-25 |