| NPI | 1528222387 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 02004009A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125-050866) |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2012-08-28 |