| NPI | 1619503604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036164390) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IL 036164390) |
| Enumeration Date | 2020-03-21 |
| Last Update Date | 2024-10-06 |