| NPI | 1710299946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: IL 036135327) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.058601) |
| 2085R0001X (Licence: IL 125058601) | |
| Enumeration Date | 2010-07-02 |
| Last Update Date | 2023-02-03 |