| NPI | 1306949367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036111174) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01059035A) |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2023-03-07 |