| NPI | 1821275082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 42150) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125-050675) |
| 207R00000X Internal Medicine (Licence: IL 036121690) | |
| Enumeration Date | 2008-01-29 |
| Last Update Date | 2023-05-24 |