| NPI | 1548610595 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 52556) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125.068044) |
| 208M00000X Hospitalist (Licence: IL 036147641) | |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2025-06-24 |