| NPI | 1902875628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036.106041) |
| Additional Taxonomies | 174400000X Specialist (Licence: IL 036106041) |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2024-11-21 |