| NPI | 1558865097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IA DO-06837) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2021026152) |
| 207R00000X Internal Medicine (Licence: IL 036164506) | |
| 207R00000X Internal Medicine (Licence: VA 0102208384) | |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MO 2021026152) | |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: IL 036164506) | |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2025-07-15 |