| NPI | 1003995697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036117824) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036-117824) |
| 208000000X Pediatrics (Licence: IL 036.117824) | |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2022-07-21 |