| NPI | 1093758047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA G89016) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036062010) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2013-07-16 |