| NPI | 1952740946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A141205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125063504) |
| Enumeration Date | 2013-06-23 |
| Last Update Date | 2025-12-04 |