| NPI | 1285884403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036.128694) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: IL 036128694) |
| 207R00000X Internal Medicine (Licence: TN 57059) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207R00000X Internal Medicine (Licence: OH 35.141208) | |
| Enumeration Date | 2008-09-24 |
| Last Update Date | 2026-04-06 |