| NPI | 1720343072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036054967) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: AZ 50110) |
| 207R00000X Internal Medicine (Licence: AZ 50110) | |
| 207R00000X Internal Medicine (Licence: IL 125061461) | |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2021-12-22 |