| NPI | 1255780185 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 125068351) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A161067) |
| Enumeration Date | 2016-06-10 |
| Last Update Date | 2024-10-15 |