| NPI | 1376771105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036125153) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 54712-20) |
| 208M00000X Hospitalist (Licence: IL 036125153) | |
| 208M00000X Hospitalist (Licence: MO 2015038767) | |
| Enumeration Date | 2009-07-01 |
| Last Update Date | 2022-11-11 |