| NPI | 1801258561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036163057) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01082068A) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2023-04-24 |