| NPI | 1679745590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine Adult Medicine (Licence: ID M-12213) |
| Additional Taxonomies | 207QA0505X Family Medicine Adult Medicine (Licence: NM MD2010-0534) |
| 208M00000X Hospitalist (Licence: IL 036.129296) | |
| Enumeration Date | 2008-04-01 |
| Last Update Date | 2013-12-06 |