| NPI | 1275069718 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036-152646) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: IL 036-152646) |
| Enumeration Date | 2017-05-03 |
| Last Update Date | 2022-07-21 |