| NPI | 1538100128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01095489A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036085478) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2026-07-15 |