| NPI | 1508111659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX T0093) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D86243) |
| 207R00000X Internal Medicine (Licence: MI 4301100829) | |
| 208M00000X Hospitalist (Licence: IL 036137654) | |
| Enumeration Date | 2012-07-16 |
| Last Update Date | 2021-07-20 |