| NPI | 1376070102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A163757) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036151172) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2025-07-25 |