| NPI | 1548713696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036167564) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A151096) |
| Enumeration Date | 2016-07-25 |
| Last Update Date | 2024-01-03 |