| NPI | 1255488896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME135095) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 65903) |
| 207Q00000X Family Medicine (Licence: IL 036121813) | |
| 208M00000X Hospitalist (Licence: IL 036-121813) | |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2023-10-03 |