| NPI | 1285702308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036-145917) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01043637A) |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2021-12-10 |