| NPI | 1760895395 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KS 04-40018) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036142956) |
| Enumeration Date | 2014-06-11 |
| Last Update Date | 2024-10-10 |