| NPI | 1619986387 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036088647) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AR E-0403) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2022-06-10 |