| NPI | 1376749341 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036130008) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036130008) |
| 207R00000X Internal Medicine (Licence: OH 57.012657) | |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2023-02-16 |