| NPI | 1205357852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01083740) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125069813) |
| Enumeration Date | 2017-07-05 |
| Last Update Date | 2022-10-14 |