| NPI | 1316520711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 1018562) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125077972) |
| Enumeration Date | 2021-05-03 |
| Last Update Date | 2025-08-18 |