| NPI | 1124468293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD462132) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125064018) |
| Enumeration Date | 2013-07-03 |
| Last Update Date | 2021-02-01 |