| NPI | 1407838444 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036062276) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO R8P34) |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2007-07-08 |