| NPI | 1619293149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036.155470) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301097035) |
| Enumeration Date | 2010-04-08 |
| Last Update Date | 2022-12-05 |