| NPI | 1669812921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.126789) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 015220584164) |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2020-11-20 |