| NPI | 1932593324 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 71545) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036144006) |
| Enumeration Date | 2015-03-24 |
| Last Update Date | 2021-11-23 |