| NPI | 1801998968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA C53422) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036103245) |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2013-06-25 |