| NPI | 1174044077 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036156840) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125071526) |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2021-09-10 |