| NPI | 1740522887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301114242) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036138964) |
| Enumeration Date | 2013-03-26 |
| Last Update Date | 2020-01-09 |