| NPI | 1992202097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036.153487) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125073107) |
| Enumeration Date | 2018-04-06 |
| Last Update Date | 2021-12-21 |