| NPI | 1720333768 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01077251A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036132602) |
| Enumeration Date | 2012-07-16 |
| Last Update Date | 2016-09-08 |