| NPI | 1265851109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 65782) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125065686) |
| 207R00000X Internal Medicine (Licence: CA A153791) | |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2022-09-13 |