| NPI | 1548352107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036-094009) |
| Additional Taxonomies | 209800000X Legal Medicine (Licence: IL 0360-94009) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2020-10-05 |