| NPI | 1669033205 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD209327) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125076911) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-06-25 |
| Last Update Date | 2022-06-21 |