| NPI | 1740644400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036.149804) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 62621) |
| Enumeration Date | 2016-04-08 |
| Last Update Date | 2024-07-26 |