| NPI | 1104121623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036147466) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 26984) |
| 207R00000X Internal Medicine (Licence: NY 263200) | |
| 207R00000X Internal Medicine (Licence: IA 40616) | |
| 207R00000X Internal Medicine (Licence: NJ 25MA08971200) | |
| 207R00000X Internal Medicine (Licence: IL 036147466) | |
| Enumeration Date | 2011-01-13 |
| Last Update Date | 2021-07-08 |