| NPI | 1124317664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036135997) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125059928) |
| Enumeration Date | 2011-04-05 |
| Last Update Date | 2021-05-10 |