| NPI | 1790070837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036134143) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2011016922) |
| Enumeration Date | 2011-06-16 |
| Last Update Date | 2024-05-08 |