| NPI | 1891919593 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0071292) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 36112202) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2014-09-17 |