| NPI | 1003253972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036-138623) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036138623) |
| Enumeration Date | 2013-05-31 |
| Last Update Date | 2020-11-12 |