| NPI | 1851321467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036101029) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036102029) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2022-01-06 |