| NPI | 1841292778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036-098320) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: IL 036-098320) |
| 207P00000X Emergency Medicine (Licence: IL 036-098320) | |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: IL 036-098320) | |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2013-05-15 |