| NPI | 1851734040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036140679) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.023013) |
| 207R00000X Internal Medicine (Licence: IL 036.140679) | |
| Enumeration Date | 2013-04-08 |
| Last Update Date | 2018-03-17 |