| NPI | 1063660652 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036123093) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036123093) |
| 207R00000X Internal Medicine (Licence: IL 036123093) | |
| Enumeration Date | 2008-09-08 |
| Last Update Date | 2021-12-21 |