| NPI | 1205056660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2009016995) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036136224) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2023-11-16 |