| NPI | 1912971243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 65437-20) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 36081211) |
| 207R00000X Internal Medicine (Licence: WI 65437) | |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2022-10-07 |