| NPI | 1285294041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036.159354) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125073719) |
| Enumeration Date | 2019-06-14 |
| Last Update Date | 2022-05-03 |