| NPI | 1063974889 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME153137) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036162486) |
| 207R00000X Internal Medicine (Licence: NM MD2022-1447) | |
| 208M00000X Hospitalist (Licence: LA 339579) | |
| 208M00000X Hospitalist (Licence: IL 036162486) | |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2024-05-30 |