| NPI | 1295454957 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036176414) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OH 35.152379) |
| Enumeration Date | 2022-08-25 |
| Last Update Date | 2025-08-05 |