| NPI | 1184063349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2013020177) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: IL 336101860) |
| Enumeration Date | 2013-06-21 |
| Last Update Date | 2016-05-07 |