| NPI | 1215347125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036.142642) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MO 2018003023) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207R00000X Internal Medicine (Licence: IL 036.142642) | |
| Enumeration Date | 2014-04-30 |
| Last Update Date | 2019-10-08 |