| NPI | 1932183530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX n8244) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036106739) |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2021-06-28 |