| NPI | 1780177238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0100197) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.072483) |
| Enumeration Date | 2018-06-10 |
| Last Update Date | 2024-05-02 |