| NPI | 1164450672 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036114268) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036114268) | 
| Enumeration Date | 2006-06-30 | 
| Last Update Date | 2024-11-26 |