| NPI | 1114191327 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IL 036119915) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH AC2895437U13) |
| Enumeration Date | 2008-04-17 |
| Last Update Date | 2012-09-27 |