| NPI | 1538194600 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036089116) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036089116) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2020-05-21 |