| NPI | 1144661034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO 0005302) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125063456) |
| Enumeration Date | 2013-07-09 |
| Last Update Date | 2015-04-02 |