| NPI | 1679924567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036149786) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036149786) |
| 207R00000X Internal Medicine (Licence: IL 125.068791) | |
| Enumeration Date | 2016-06-22 |
| Last Update Date | 2022-05-25 |