| NPI | 1780693648 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX M3836) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036166943) |
| 208M00000X Hospitalist (Licence: ID M-16070) | |
| 208M00000X Hospitalist (Licence: IL 036166943) | |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2024-10-16 |