| NPI | 1659544203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A102305) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL O36.120147) |
| Enumeration Date | 2008-04-03 |
| Last Update Date | 2011-11-23 |