| NPI | 1194133850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036-142270) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125064732) |
| Enumeration Date | 2014-07-25 |
| Last Update Date | 2017-05-09 |