| 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 |