| NPI | 1114982352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036091652) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036091652) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2024-11-13 |