| NPI | 1093778359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD429319) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036113231) |
| Enumeration Date | 2006-04-08 |
| Last Update Date | 2017-01-12 |