| NPI | 1609164292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036.135748) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125060642) |
| 207R00000X Internal Medicine (Licence: WA MD60441616) | |
| 207R00000X Internal Medicine (Licence: IL 036135748) | |
| Enumeration Date | 2011-07-16 |
| Last Update Date | 2021-02-05 |