| NPI | 1295781680 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036157173) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 34584) |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2021-07-29 |