| NPI | 1588825228 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2011017860) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2011017860) |
| 207Q00000X Family Medicine (Licence: IL 125-054995) | |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2021-03-19 |