| NPI | 1295768778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036-093459) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036093459) |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2025-04-24 |