| NPI | 1538101886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036153018) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ME 1814) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2021-05-13 |