| NPI | 1972590628 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 18587) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036056621) |
| Enumeration Date | 2005-09-28 |
| Last Update Date | 2019-08-26 |