| NPI | 1104951250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: IL 036101988) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036-101988) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2021-04-27 |