| NPI | 1972543239 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036126956) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A76587) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2024-07-24 |