| NPI | 1952759516 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IL 036148405) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 1952759516) |
| 207R00000X Internal Medicine (Licence: IL 036148405) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125.068621) | |
| Enumeration Date | 2016-05-24 |
| Last Update Date | 2022-05-24 |