| NPI | 1255773396 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MT204675)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036163787)  | 
| 207R00000X Internal Medicine (Licence: IN 01079584A)  | |
| 208M00000X Hospitalist (Licence: IL 036163787)  | |
| Enumeration Date | 2013-07-17 | 
| Last Update Date | 2024-08-29 |