| NPI | 1124645114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036.163559) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.076867) |
| 207R00000X Internal Medicine (Licence: WI 101402) | |
| Enumeration Date | 2020-06-25 |
| Last Update Date | 2024-09-17 |