| NPI | 1447267810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036068336) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO R4C28) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2021-03-04 |