| NPI | 1952928319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 125075876) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DE C1-0027473) |
| Enumeration Date | 2020-07-01 |
| Last Update Date | 2024-10-23 |