| NPI | 1649279274 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036-083414) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 036083414) |
| Enumeration Date | 2005-07-15 |
| Last Update Date | 2021-12-16 |