| NPI | 1295020097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2017016278) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125059355) |
| Enumeration Date | 2011-06-09 |
| Last Update Date | 2024-05-08 |