| NPI | 1952680225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036134976) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036134976) |
| 207R00000X Internal Medicine (Licence: IL 125059130) | |
| 208M00000X Hospitalist (Licence: WI 64884) | |
| Enumeration Date | 2011-08-04 |
| Last Update Date | 2021-03-23 |