| NPI | 1912371725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 125.073573) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: IL 036159512) |
| Enumeration Date | 2015-11-17 |
| Last Update Date | 2026-06-03 |