| NPI | 1073997672 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036-146203)  | 
| Additional Taxonomies | 208M00000X Hospitalist (Licence: IL 036-146203)  | 
| Enumeration Date | 2015-07-13 | 
| Last Update Date | 2021-04-28 |