| NPI | 1427549005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 125072190) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 327872) |
| Enumeration Date | 2018-05-19 |
| Last Update Date | 2025-07-28 |