| NPI | 1902143605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036131430) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: IL 036131430) |
| Enumeration Date | 2013-01-15 |
| Last Update Date | 2014-06-16 |