| NPI | 1013290451 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036155946) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI MD14980) |
| Enumeration Date | 2011-09-22 |
| Last Update Date | 2024-10-15 |