| NPI | 1073595310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036.168113) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 15785) |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2024-01-08 |