| NPI | 1013538248 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0096778)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125075888)  | 
| Enumeration Date | 2020-04-28 | 
| Last Update Date | 2023-07-03 |