| NPI | 1164009023 |
|---|---|
| Former Name | ANDREW STEPHEN VIDALIS |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: IL 036.167216) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.077394) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-03-26 |
| Last Update Date | 2024-06-27 |