| NPI | 1538137914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 14813) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036108353) |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2015-12-17 |