| NPI | 1265408694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036.12223) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: NY 230554) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: IL 036.12223) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 230554) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036.12223) | |
| Enumeration Date | 2006-02-26 |
| Last Update Date | 2020-01-07 |