| NPI | 1699787150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD425724) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: IL 036145154) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2025-12-11 |