| NPI | 1437544863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 69363-20) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125066444) |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2018-07-25 |