| NPI | 1417067778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036094269) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01046559A) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2013-02-08 |