| NPI | 1609142801 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: VA 0101273436)  | 
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: IL 036137940)  | 
| 207R00000X Internal Medicine (Licence: IL 125061089)  | |
| Enumeration Date | 2012-04-01 | 
| Last Update Date | 2021-11-11 |