| NPI | 1740664499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301108384) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MI 4301108384) |
| 207R00000X Internal Medicine (Licence: IL 036-151246) | |
| 208M00000X Hospitalist (Licence: IL 036-151246) | |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2020-01-15 |