| NPI | 1538699079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01095915A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036156110) |
| Enumeration Date | 2017-06-18 |
| Last Update Date | 2025-09-05 |