| NPI | 1659767903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036-146220) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036146220) |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: IL 036-146220) | |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: MN 65771) | |
| Enumeration Date | 2015-04-14 |
| Last Update Date | 2025-09-02 |