| NPI | 1023577939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036166298) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 330478) |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2023-10-04 |