| NPI | 1689803652 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 080202) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125055845) |
| 207R00000X Internal Medicine (Licence: IA 40328) | |
| Enumeration Date | 2009-07-10 |
| Last Update Date | 2018-09-05 |