| NPI | 1235224643 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036100301) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 61050388A) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2012-06-13 |