| NPI | 1740711100 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IL 036174826) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036174826) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207R00000X Internal Medicine (Licence: PA MT214318) | |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2025-07-01 |