| NPI | 1104849991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036-111841) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX M0857) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2022-07-21 |