| NPI | 1184633216 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 26362) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125013044) |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2007-07-08 |