| NPI | 1356427736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036119956) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2006030252) |
| Enumeration Date | 2006-10-28 |
| Last Update Date | 2010-09-16 |