| NPI | 1376719781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 510102814) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036119681) |
| Enumeration Date | 2008-05-06 |
| Last Update Date | 2020-12-23 |