| NPI | 1164716742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036.135440) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MO 2014010518) |
| Enumeration Date | 2011-06-01 |
| Last Update Date | 2015-11-11 |