| NPI | 1457342610 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036095779) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01060676A) |
| 207R00000X Internal Medicine (Licence: WI 50075) | |
| Enumeration Date | 2005-11-04 |
| Last Update Date | 2024-11-26 |