| NPI | 1245334721 |
|---|---|
| Former Name | ZAZA KOYENISHVILI |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NJ 25MA07622700) |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NJ 25MA07622700) |
| 207R00000X Internal Medicine (Licence: NJ 25MA07622700) | |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2014-02-28 |