| NPI | 1710032131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 38638) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036164869) |
| 208M00000X Hospitalist (Licence: AZ 28999) | |
| 208M00000X Hospitalist (Licence: IL 036164869) | |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2025-03-31 |