| NPI | 1417903212 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 3366037583) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036074034) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2024-03-25 |