| NPI | 1972725083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301099600) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.010416) |
| 207R00000X Internal Medicine (Licence: IL 036159323) | |
| 208M00000X Hospitalist (Licence: IL 036159323) | |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2022-05-09 |