| NPI | 1922085372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036.109431) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: IL 036.109431) |
| 174400000X Specialist | |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2021-09-14 |