| NPI | 1154797561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01081413A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.066542) |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2022-10-11 |