| NPI | 1013277714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036136062) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036136062) |
| 208M00000X Hospitalist (Licence: WI 64397) | |
| 207Q00000X Family Medicine (Licence: WI 64397) | |
| Enumeration Date | 2012-05-29 |
| Last Update Date | 2026-07-23 |