| NPI | 1639163850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036.092485) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036092485) |
| Enumeration Date | 2005-09-02 |
| Last Update Date | 2023-01-20 |