| NPI | 1407207699 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036148527) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2023011938) |
| Enumeration Date | 2016-06-28 |
| Last Update Date | 2024-02-15 |