| NPI | 1235467283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036131545) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036131545) |
| 207R00000X Internal Medicine (Licence: WI 53908-20) | |
| Enumeration Date | 2009-12-03 |
| Last Update Date | 2018-06-18 |