| NPI | 1437611761 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: IL 036.170440) |
| Additional Taxonomies | 2085R0001X (Licence: IL 125.073608) |
| 207R00000X Internal Medicine (Licence: IL 125.073608) | |
| Enumeration Date | 2019-04-04 |
| Last Update Date | 2026-05-22 |