| NPI | 1962571596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036171859) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101224017) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2025-01-20 |