| NPI | 1104147214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036145820) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 11015290A) |
| 208M00000X Hospitalist (Licence: MO 2013016093) | |
| Enumeration Date | 2010-06-14 |
| Last Update Date | 2024-03-13 |