| NPI | 1205496312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036168576) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2019021211) |
| Enumeration Date | 2019-06-20 |
| Last Update Date | 2024-11-27 |