| NPI | 1134560170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036139376) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301507589) |
| Enumeration Date | 2013-07-06 |
| Last Update Date | 2026-07-14 |