| NPI | 1821570664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: WI 83000) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125073046) |
| Enumeration Date | 2018-08-29 |
| Last Update Date | 2023-12-05 |