| NPI | 1225088693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 39514) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036085264) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2019-02-19 |