| NPI | 1417570268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 125076598) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036165534) |
| 207R00000X Internal Medicine (Licence: IL 125.076598) | |
| Enumeration Date | 2020-05-27 |
| Last Update Date | 2023-07-07 |