| NPI | 1164876595 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036.150215) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036.150215) |
| 208M00000X Hospitalist (Licence: MO 2020004312) | |
| Enumeration Date | 2016-04-22 |
| Last Update Date | 2021-11-09 |