| NPI | 1134432016 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: RI MD14524) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 245291) |
| Enumeration Date | 2010-07-20 |
| Last Update Date | 2014-03-28 |