| NPI | 1023677960 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: IL 036175171) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP04706) | 
| 207R00000X Internal Medicine (Licence: NY 316957-01) | |
| Enumeration Date | 2019-06-12 | 
| Last Update Date | 2025-08-21 |