| NPI | 1760904908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NY 306409) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 306409) |
| 207R00000X Internal Medicine (Licence: IL 125.070188) | |
| Enumeration Date | 2017-07-10 |
| Last Update Date | 2024-06-20 |