| NPI | 1083143515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 85318) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125069914) |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2023-01-30 |