| NPI | 1629603139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036162150) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.079034) |
| 207R00000X Internal Medicine (Licence: IL 125079034) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-03-04 |
| Last Update Date | 2023-09-26 |