| NPI | 1790986024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MO 2003025337) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: IL 036-118331) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2014-08-07 |