| NPI | 1083600050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IA 39883) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036094399) |
| 207R00000X Internal Medicine (Licence: IL 036094399) | |
| Enumeration Date | 2005-09-23 |
| Last Update Date | 2011-12-13 |