| NPI | 1356737076 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036149584) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125066785) |
| Enumeration Date | 2015-04-09 |
| Last Update Date | 2020-10-25 |