| NPI | 1821589110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 125.073262) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01087936A) |
| Enumeration Date | 2018-05-23 |
| Last Update Date | 2022-07-20 |