| NPI | 1821404781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A170435) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125064843) |
| Enumeration Date | 2014-07-10 |
| Last Update Date | 2026-05-26 |