| NPI | 1518252386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036136679) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01074584A) |
| Enumeration Date | 2011-06-09 |
| Last Update Date | 2019-09-26 |