| NPI | 1689976649 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036.128738) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125055608) |
| Enumeration Date | 2010-11-24 |
| Last Update Date | 2022-07-21 |