| NPI | 1942730742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036.152073) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036.152073) |
| 207R00000X Internal Medicine (Licence: IL 125.070711) | |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2020-10-21 |