| NPI | 1902219611 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 2489-320)  | 
| Additional Taxonomies | 208M00000X Hospitalist (Licence: IN 01086875A)  | 
| 207R00000X Internal Medicine (Licence: IN 01086875A)  | |
| 207R00000X Internal Medicine (Licence: MO 2017021754)  | |
| 207R00000X Internal Medicine (Licence: IL 036.143268)  | |
| 208M00000X Hospitalist (Licence: IL 036.143268)  | |
| 207R00000X Internal Medicine (Licence: OH 35.152109)  | |
| Enumeration Date | 2014-06-10 | 
| Last Update Date | 2025-06-02 |