| NPI | 1659773901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036142080) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DE C1-0024869) |
| Enumeration Date | 2014-09-18 |
| Last Update Date | 2022-04-27 |