| NPI | 1952700973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036142462) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125065288) |
| Enumeration Date | 2014-08-14 |
| Last Update Date | 2022-07-21 |