| NPI | 1972035798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: IL 036159514) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.069873) |
| Enumeration Date | 2017-03-30 |
| Last Update Date | 2022-08-02 |