| NPI | 1487850996 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036-129700) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.096920) |
| 208000000X Pediatrics (Licence: OH 35.096920) | |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2025-04-07 |