| NPI | 1528404407 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA MD-46493) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: IL 036-141203) |
| 207Q00000X Family Medicine (Licence: IL 036141203) | |
| Enumeration Date | 2013-05-17 |
| Last Update Date | 2021-03-31 |