| NPI | 1154973436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036158779) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2024039249) |
| 207R00000X Internal Medicine (Licence: IL 125.075294) | |
| Enumeration Date | 2019-07-16 |
| Last Update Date | 2025-07-14 |