| NPI | 1083673594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01059339) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 0361188481) |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2020-11-19 |