| NPI | 1457734808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036144376) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2022032139) |
| Enumeration Date | 2015-07-02 |
| Last Update Date | 2024-03-06 |