| NPI | 1295230159 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036155611) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125071904) |
| 207R00000X Internal Medicine (Licence: IL 036.155061) | |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2022-04-04 |