| NPI | 1063675619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036129148) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036129148) |
| 207R00000X Internal Medicine (Licence: WI 64184-20) | |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: WI 64184-20) | |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2024-01-15 |