| NPI | 1881973147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME111803) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 48453) |
| 207R00000X Internal Medicine (Licence: IL 036.139108) | |
| 207R00000X Internal Medicine (Licence: MI 5315078849) | |
| 207R00000X Internal Medicine (Licence: AL MD.41475) | |
| 208M00000X Hospitalist (Licence: KY 48453) | |
| Enumeration Date | 2011-08-04 |
| Last Update Date | 2021-02-15 |