| NPI | 1083095814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 70382-20) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301107861) |
| 208M00000X Hospitalist (Licence: IL 036156533) | |
| 208M00000X Hospitalist (Licence: WI 70382-20) | |
| Enumeration Date | 2015-06-17 |
| Last Update Date | 2024-05-10 |