| NPI | 1679689939 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: IL 3657912)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 3657912)  | 
| Enumeration Date | 2006-08-21 | 
| Last Update Date | 2025-09-11 |