| NPI | 1003881699 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036106200) |
| Additional Taxonomies | 207RG0300X Internal Medicine Geriatric Medicine (Licence: IL 036-106200) |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2021-01-06 |