| NPI | 1548656747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036146913) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036146913) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MO 2015017276) | |
| 207Q00000X Family Medicine (Licence: IL 036146913) | |
| Enumeration Date | 2015-04-14 |
| Last Update Date | 2018-07-23 |