| NPI | 1164497525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036-147746) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MO 2009021594) |
| 207R00000X Internal Medicine (Licence: KS 04-34405) | |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2026-05-13 |