| NPI | 1215142310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036087676) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY TP976) |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2018-10-05 |