NPI | 1225527138 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036165379) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 312615) |
208000000X Pediatrics (Licence: LA 312615) | |
Enumeration Date | 2018-05-07 |
Last Update Date | 2024-08-01 |