| NPI | 1962936153 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036.180417) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD470271) |
| Enumeration Date | 2017-04-14 |
| Last Update Date | 2026-06-09 |