| NPI | 1801234810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036139365) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125063549) |
| 207R00000X Internal Medicine (Licence: IN 01083961) | |
| 208M00000X Hospitalist (Licence: MO 2016025627) | |
| Enumeration Date | 2013-06-12 |
| Last Update Date | 2021-07-08 |