| NPI | 1043754310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036147906) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036147906) |
| 208M00000X Hospitalist (Licence: WI 66375-20) | |
| 207Q00000X Family Medicine (Licence: WI 66375-20) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: WI 66375-20) | |
| Enumeration Date | 2016-12-06 |
| Last Update Date | 2023-06-20 |