| NPI | 1144606583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036149802) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2018-01754) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-08-08 |
| Last Update Date | 2022-01-11 |