| NPI | 1982916425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036-133965) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125.057666) |
| 208M00000X Hospitalist (Licence: IL 036-133965) | |
| Enumeration Date | 2010-07-13 |
| Last Update Date | 2021-04-26 |