| NPI | 1326271909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036132637) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125056216) |
| Enumeration Date | 2009-08-28 |
| Last Update Date | 2013-09-25 |