NPI | 1053833343 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: IL 085006142) |
Additional Taxonomies | 207RN0300X Internal Medicine Nephrology (Licence: IL 085.006142) |
Enumeration Date | 2017-07-09 |
Last Update Date | 2022-07-21 |