| NPI | 1790888931 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 55172) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01062585A) |
| 207R00000X Internal Medicine (Licence: IL 036111812) | |
| 208M00000X Hospitalist (Licence: IL 036-111812) | |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2020-11-19 |