| NPI | 1063823763 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 69793-21) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: IL 036151501) |
| Enumeration Date | 2014-05-15 |
| Last Update Date | 2022-08-11 |