| NPI | 1831486281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036141735) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125054037) |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2017-04-27 |