| NPI | 1760699623 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036123162) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP00391) | 
| Enumeration Date | 2007-05-17 | 
| Last Update Date | 2021-07-09 |