| NPI | 1114346657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2023008879) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA a145010) |
| 208M00000X Hospitalist (Licence: IL 036174946) | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: FL ME182762) | |
| 2084A2900X Psychiatry & Neurology, Neurocritical Care (Licence: GA 109332) | |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2026-06-29 |