| NPI | 1528564374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036155812) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036.155812) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IL 036.155812) | |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2022-03-15 |