| NPI | 1972591527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036111599) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: IL 036111599) |
| Enumeration Date | 2005-10-07 |
| Last Update Date | 2022-07-22 |