| NPI | 1720433220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036154477) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV 18907) |
| Enumeration Date | 2016-05-03 |
| Last Update Date | 2023-11-27 |