| NPI | 1871021030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX T6381) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036.152922) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: AZ 72581) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MN 3016) | |
| 208M00000X Hospitalist (Licence: IL 036.152922) | |
| Enumeration Date | 2017-05-31 |
| Last Update Date | 2024-03-29 |