| NPI | 1518443308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036154024) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036154024) |
| 207R00000X Internal Medicine (Licence: IL 125.071775) | |
| Enumeration Date | 2018-07-14 |
| Last Update Date | 2021-05-20 |