| NPI | 1609039130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036127854) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125054504) |
| 207R00000X Internal Medicine (Licence: FL ME118225) | |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2021-02-19 |