| NPI | 1437151974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036126913) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301051783) |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2011-03-11 |