| NPI | 1215243027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: IL 036137508) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125058721) |
| 207R00000X Internal Medicine (Licence: NV SL0829) | |
| Enumeration Date | 2010-08-31 |
| Last Update Date | 2017-03-02 |