| NPI | 1497106983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2019022614) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: IL 036169509) |
| 207Q00000X Family Medicine (Licence: IL 125.068402) | |
| Enumeration Date | 2016-06-26 |
| Last Update Date | 2025-09-19 |