| NPI | 1881957611 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036141499) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036141499) |
| 207Q00000X Family Medicine (Licence: MI 4301107124) | |
| Enumeration Date | 2012-06-18 |
| Last Update Date | 2023-07-25 |