| NPI | 1164198420 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: IL 125079126) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WI 84910-20) |
| Enumeration Date | 2021-08-17 |
| Last Update Date | 2025-09-28 |