| NPI | 1972023000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036.119704) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: IL 036.119704) |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2023-12-01 |