| NPI | 1114966611 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036-076188) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 36076188) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2021-02-23 |