| NPI | 1457513566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036134410) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: IN 01069203A) |
| 208M00000X Hospitalist (Licence: AZ 45066) | |
| 208M00000X Hospitalist (Licence: IL 036134410) | |
| 207Q00000X Family Medicine (Licence: IN 01069203A) | |
| 207R00000X Internal Medicine (Licence: AZ 45066) | |
| 208M00000X Hospitalist (Licence: WI 63291) | |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2025-07-08 |