| NPI | 1851013254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036175071) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01099797A) |
| Enumeration Date | 2022-09-13 |
| Last Update Date | 2026-05-04 |