| NPI | 1578511176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 36093495) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: IL 36093495) |
| 207R00000X Internal Medicine (Licence: MO 2020011670) | |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: VT 042.0040074-COMP) | |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2026-04-22 |