| NPI | 1881951630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036138712) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01098529A) |
| Enumeration Date | 2012-04-18 |
| Last Update Date | 2026-07-06 |