| NPI | 1396729554 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036-067726) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036067726) |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2016-08-11 |