| NPI | 1437700234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209020075) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: IL 209.020075) |
| Enumeration Date | 2019-09-23 |
| Last Update Date | 2019-10-31 |