| NPI | 1093097735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036.133914) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV 15335) |
| Enumeration Date | 2011-09-19 |
| Last Update Date | 2020-04-15 |