| NPI | 1255630422 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036137830) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036137830) |
| 208000000X Pediatrics (Licence: IL 036137830) | |
| Enumeration Date | 2011-03-27 |
| Last Update Date | 2021-12-17 |