| NPI | 1285692889 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036096907) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 36096907) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2023-02-02 |