| NPI | 1376782870 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036-054784) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: IL 036-054784) |
| 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: IL 36-054784) | |
| Enumeration Date | 2009-02-07 |
| Last Update Date | 2009-02-07 |