| NPI | 1124274063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036-128216) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 26478) |
| 208M00000X Hospitalist (Licence: IL 036-128216) | |
| Enumeration Date | 2008-08-12 |
| Last Update Date | 2018-11-13 |