| NPI | 1275157844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036-163780) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125076178) |
| Enumeration Date | 2020-05-30 |
| Last Update Date | 2023-07-06 |