NPI | 1720444110 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036146057) |
Additional Taxonomies | 208M00000X Hospitalist (Licence: IL 036145571) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: AL L4198R) | |
207Q00000X Family Medicine (Licence: IL 036146057) | |
Enumeration Date | 2016-01-14 |
Last Update Date | 2022-09-27 |