| NPI | 1497331847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036172311) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301509894) |
| 208D00000X General Practice (Licence: MI 4301509894) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4351050340) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125078523) | |
| Enumeration Date | 2021-03-23 |
| Last Update Date | 2025-01-09 |