| NPI | 1285792127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 38003) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036097890) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2023-09-20 |