| NPI | 1477291334 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036174976) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125079980) |
| Enumeration Date | 2022-05-21 |
| Last Update Date | 2025-08-07 |