| NPI | 1366001232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036163760) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 070075) |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2023-09-11 |