| NPI | 1902287956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 125-066822) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: IL 036.144704) |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2024-05-30 |