| NPI | 1164981981 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036.169232) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036169232) |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2025-02-17 |