| NPI | 1679968432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036148524) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: GA 110044) |
| 208M00000X Hospitalist (Licence: WI 69575-20) | |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2025-10-12 |