| NPI | 1275026197 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036.160018) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.071882) |
| 208000000X Pediatrics (Licence: IL 125.071882) | |
| Enumeration Date | 2018-06-14 |
| Last Update Date | 2022-07-05 |