| NPI | 1720444110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036146057) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036146057) |
| 208M00000X Hospitalist (Licence: IL 036145571) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: AL L4198R) | |
| Enumeration Date | 2016-01-14 |
| Last Update Date | 2025-02-28 |