| NPI | 1295815645 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036101498) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: IL 036101498) |
| 208M00000X Hospitalist (Licence: GA 76499) | |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2025-08-27 |