| NPI | 1144614447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 20A16199) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125066341) |
| Enumeration Date | 2015-03-25 |
| Last Update Date | 2021-12-08 |