| NPI | 1518548387 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036173725) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.080957) |
| Enumeration Date | 2021-04-14 |
| Last Update Date | 2025-07-06 |