| NPI | 1558802751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036158834) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 04597) |
| 207R00000X Internal Medicine (Licence: WY 14130C) | |
| 207R00000X Internal Medicine (Licence: IL 036158834) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2022-12-30 |