| NPI | 1043549850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036.131856) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.057280) |
| Enumeration Date | 2009-12-08 |
| Last Update Date | 2014-07-16 |