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 |