| NPI | 1235340621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036144200) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.125738) |
| 207R00000X Internal Medicine (Licence: RI MD13086) | |
| 207R00000X Internal Medicine (Licence: WI 65845-20) | |
| 207R00000X Internal Medicine (Licence: IL 036144200) | |
| 207R00000X Internal Medicine (Licence: IN 01083788A) | |
| 208M00000X Hospitalist (Licence: WI 65845) | |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2022-04-05 |