| NPI | 1467943308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036156874) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.072366) |
| Enumeration Date | 2018-05-26 |
| Last Update Date | 2025-04-03 |