| NPI | 1073777579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: IL 036116640) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036116640) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 036116640) | |
| Enumeration Date | 2008-07-14 |
| Last Update Date | 2010-08-30 |