| NPI | 1770076929 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036155536) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.071976) | 
| Enumeration Date | 2018-06-12 | 
| Last Update Date | 2021-07-09 |