| NPI | 1568665917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01069011A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 36117198) |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2020-10-13 |