| NPI | 1932735875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036.168471) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 1013247) |
| Enumeration Date | 2020-03-22 |
| Last Update Date | 2024-05-03 |