| NPI | 1417188418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036129713) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125055600) |
| Enumeration Date | 2009-08-07 |
| Last Update Date | 2016-09-01 |