| NPI | 1427128909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036068108) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036068108) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2021-01-05 |