| NPI | 1669822318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IA DO-05738) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125.068964) |
| 207Q00000X Family Medicine (Licence: IA DO-05738) | |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2024-01-17 |