| NPI | 1407915978 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 63951) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036086127) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2022-07-21 |