| NPI | 1639367865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 64525) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57-013026) |
| 207R00000X Internal Medicine (Licence: IL 036.125324) | |
| 208M00000X Hospitalist (Licence: IL 036125324) | |
| Enumeration Date | 2007-10-12 |
| Last Update Date | 2018-09-11 |