| NPI | 1063894780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036146985) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO TL.0005734) |
| 207R00000X Internal Medicine (Licence: IL 036146985) | |
| Enumeration Date | 2015-06-19 |
| Last Update Date | 2021-07-08 |