| NPI | 1619430535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036.163994) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10067169) |
| Enumeration Date | 2019-04-08 |
| Last Update Date | 2023-05-26 |