| NPI | 1154525707 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2011040558) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036118425) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2023-06-06 |