| NPI | 1962506238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 20A9614) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036093708) |
| Enumeration Date | 2006-09-08 |
| Last Update Date | 2018-11-19 |