| NPI | 1033114939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036-089936) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036089936) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: IL 036089936) | |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2008-11-20 |