| NPI | 1700183142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2016009817) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036135693) |
| Enumeration Date | 2011-02-21 |
| Last Update Date | 2024-08-21 |