| NPI | 1225456296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 69423-20) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036142168) |
| Enumeration Date | 2014-04-06 |
| Last Update Date | 2021-11-30 |