| NPI | 1366657702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036116775) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 50668-020) |
| 207Q00000X Family Medicine (Licence: IL 036-116775) | |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2021-11-02 |