| NPI | 1639307283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: IL 036129801) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036129081) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125056547) | |
| Enumeration Date | 2009-06-22 |
| Last Update Date | 2021-07-20 |