| NPI | 1386965499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036133193) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.058047) |
| 207R00000X Internal Medicine (Licence: MO 2013004979) | |
| Enumeration Date | 2010-06-14 |
| Last Update Date | 2018-12-10 |