| NPI | 1164480505 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036061168) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036061168) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: IL 036061168) | |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2021-07-19 |