| NPI | 1922132562 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX N 4342) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036108095) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2024-12-31 |