| NPI | 1598489692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036173646) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT227003) |
| Enumeration Date | 2022-10-03 |
| Last Update Date | 2025-08-08 |