| NPI | 1518279843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL MD.32653) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.058513) |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2015-12-02 |