| NPI | 1043325335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036-107780) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ND 5894) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2013-05-21 |