| NPI | 1326500042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036-160287) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 1326500042) |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2022-10-24 |