| NPI | 1811333735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036153124) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0086702) |
| Enumeration Date | 2013-05-19 |
| Last Update Date | 2025-12-01 |