| NPI | 1659579613 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2016008067) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036126330) |
| 208M00000X Hospitalist (Licence: IL 036126330) | |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2019-10-24 |