| NPI | 1174600753 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 060936) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036-113112) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2022-01-13 |