| NPI | 1609019918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 14302) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036122547) |
| 207R00000X Internal Medicine (Licence: CA C161085) | |
| Enumeration Date | 2009-04-16 |
| Last Update Date | 2023-08-09 |