| NPI | 1215422142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036157041) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125072619) |
| Enumeration Date | 2018-06-23 |
| Last Update Date | 2022-12-20 |