| NPI | 1588360861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209-027259) |
| Additional Taxonomies | 163WX0200X Registered Nurse, Oncology (Licence: IL 041455486) |
| Enumeration Date | 2023-02-07 |
| Last Update Date | 2023-07-27 |