| NPI | 1225123615 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036-106803) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD00041640) |
| 208M00000X Hospitalist (Licence: IL 036-106803) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2020-07-29 |