| NPI | 1265421218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036.150546) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 108377) |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2026-03-31 |