| NPI | 1467855973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301503814) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 36143604) |
| 207R00000X Internal Medicine (Licence: TX R7590) | |
| Enumeration Date | 2014-09-29 |
| Last Update Date | 2024-05-21 |