| NPI | 1497765309 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036-100825) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA C168171) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2020-10-29 |