| NPI | 1952624868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 43238) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036124031) |
| Enumeration Date | 2010-03-05 |
| Last Update Date | 2023-03-31 |