| NPI | 1922130202 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036116517)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036-116517)  | 
| Enumeration Date | 2007-03-12 | 
| Last Update Date | 2021-12-22 |