| NPI | 1255861647 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 314553) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0102206348) |
| 207R00000X Internal Medicine (Licence: IL 125071146) | |
| 208D00000X General Practice (Licence: IL 036.151100) | |
| 208M00000X Hospitalist (Licence: VA 0102206348) | |
| Enumeration Date | 2017-06-18 |
| Last Update Date | 2023-01-17 |