| NPI | 1659687788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 125056092) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2020-02282) |
| 207R00000X Internal Medicine (Licence: MS 22638) | |
| Enumeration Date | 2010-08-26 |
| Last Update Date | 2020-05-26 |