| NPI | 1164721528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036-140244) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036.140244) |
| 208M00000X Hospitalist (Licence: OH 34.011420) | |
| 208M00000X Hospitalist (Licence: OH 011420) | |
| Enumeration Date | 2011-03-23 |
| Last Update Date | 2025-09-30 |