| NPI | 1326276486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036-131222) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125057170) |
| 207Q00000X Family Medicine (Licence: IL 036-131222) | |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2012-11-02 |