| NPI | 1558094094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 125081064) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4351055475) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207RN0300X Internal Medicine, Nephrology (Licence: IL 125081064) | |
| Enumeration Date | 2022-07-01 |
| Last Update Date | 2025-09-20 |