| NPI | 1922701176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 125.081986) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125.081986) |
| Enumeration Date | 2023-03-27 |
| Last Update Date | 2023-06-27 |