| NPI | 1154618916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036151099) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LPO2368) |
| 207R00000X Internal Medicine (Licence: FL ME133124) | |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2023-02-13 |