| NPI | 1164716502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CT 068187) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 068187) |
| 207R00000X Internal Medicine (Licence: IL 036.134865) | |
| 207R00000X Internal Medicine (Licence: MI 4301106905) | |
| 208M00000X Hospitalist (Licence: IL 036.134865) | |
| Enumeration Date | 2011-06-02 |
| Last Update Date | 2025-01-22 |