| NPI | 1881009637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036142687) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: IL 036142687) |
| 208M00000X Hospitalist (Licence: WI 21850) | |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2022-02-07 |