| NPI | 1780259762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036-170927) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125078163) |
| Enumeration Date | 2021-05-23 |
| Last Update Date | 2024-09-12 |