| NPI | 1134112824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 45397) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036111922) |
| Enumeration Date | 2005-08-26 |
| Last Update Date | 2023-09-20 |