| NPI | 1659335065 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA G148037) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036088718) |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2022-07-06 |