| NPI | 1073551594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036102808) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036102808) |
| 207RA0000X Internal Medicine Adolescent Medicine (Licence: IL 036-102808) | |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2023-06-21 |