| NPI | 1164442703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036123199) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036123199) |
| 207R00000X Internal Medicine (Licence: IL 036-123199) | |
| 207R00000X Internal Medicine (Licence: CA A89789) | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2021-12-22 |