| NPI | 1841648995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: IL 124.068244) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.068244) |
| Enumeration Date | 2016-05-31 |
| Last Update Date | 2024-05-20 |