| NPI | 1699705293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO R6047) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036-056278) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2008-06-20 |