| NPI | 1881031755 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036131099) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036131099) | 
| Enumeration Date | 2013-05-31 | 
| Last Update Date | 2020-10-30 |