| NPI | 1639463532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: HI MD-22307) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036134500) |
| 207R00000X Internal Medicine (Licence: MA 247547) | |
| Enumeration Date | 2011-06-08 |
| Last Update Date | 2022-03-09 |