| NPI | 1407879695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036124548) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 31819-021) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2019-11-01 |