| NPI | 1154702116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036-146676) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125067480) |
| 207Q00000X Family Medicine (Licence: IL 036-146676) | |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2026-07-06 |