| NPI | 1396710042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036122417) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 47761) |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2010-02-08 |