| NPI | 1689025108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036151464) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA 46317) |
| 207Q00000X Family Medicine (Licence: AZ 62970) | |
| 207Q00000X Family Medicine (Licence: KY C0107) | |
| 207Q00000X Family Medicine (Licence: MI 4301110189) | |
| 207Q00000X Family Medicine (Licence: OH 35.141082) | |
| 207Q00000X Family Medicine (Licence: WI 1147-320) | |
| 207Q00000X Family Medicine (Licence: TX T3037) | |
| 208M00000X Hospitalist (Licence: IN 01085324A) | |
| 208M00000X Hospitalist (Licence: IL 036.151464) | |
| Enumeration Date | 2016-06-27 |
| Last Update Date | 2023-08-10 |