| NPI | 1518171172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0000X Internal Medicine, Adolescent Medicine (Licence: VA 0101245827) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036118975) |
| 207R00000X Internal Medicine (Licence: IL 125048861) | |
| 207RA0000X Internal Medicine, Adolescent Medicine (Licence: MD D0067782) | |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2021-06-28 |