| NPI | 1063777464 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: RI DO00819) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI DO00819) |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2021-05-07 |