| NPI | 1154019131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 82218-21) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125081387) |
| Enumeration Date | 2023-04-27 |
| Last Update Date | 2026-09-10 |