| NPI | 1780619957 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO MD 104712) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: IL 036092474) |
| 208M00000X Hospitalist (Licence: MO 104712) | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2021-02-22 |