| NPI | 1780034926 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036149433) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125068327) |
| 207Q00000X Family Medicine (Licence: IL 036149433) | |
| Enumeration Date | 2016-06-19 |
| Last Update Date | 2021-06-15 |