| NPI | 1952614893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: IL 036126938) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125055097) |
| 207Q00000X Family Medicine (Licence: IL 036126938) | |
| Enumeration Date | 2010-07-21 |
| Last Update Date | 2025-06-13 |