| NPI | 1346728656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 125071713) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A174544) |
| Enumeration Date | 2018-07-30 |
| Last Update Date | 2022-10-19 |