| NPI | 1770105769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036.163604) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125075898) |
| Enumeration Date | 2020-05-12 |
| Last Update Date | 2024-02-27 |