| NPI | 1063676674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A119683) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125054175) |
| Enumeration Date | 2008-07-12 |
| Last Update Date | 2013-07-26 |