| NPI | 1235265083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 12583) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125047334) |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2019-12-09 |