| NPI | 1316506066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A188237) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036.162129) |
| Enumeration Date | 2019-06-06 |
| Last Update Date | 2025-07-14 |