| NPI | 1013013119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036096382) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 36-096382) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2025-07-28 |