| NPI | 1205220506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KS 0447663) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036151083) |
| 207Q00000X Family Medicine (Licence: KS 0447663) | |
| 207R00000X Internal Medicine (Licence: WI 69426) | |
| Enumeration Date | 2015-03-24 |
| Last Update Date | 2024-11-21 |