| NPI | 1114964301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: RI MD07323) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 160428) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2016-09-12 |