| NPI | 1003833625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036083081) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036083081) |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: IL 036083081) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2019-03-16 |