| NPI | 1023004587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01068370A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036-092203) |
| Enumeration Date | 2005-09-21 |
| Last Update Date | 2022-11-21 |