| NPI | 1427343938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036135245) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10041524) |
| Enumeration Date | 2011-06-13 |
| Last Update Date | 2021-02-18 |