| NPI | 1184910481 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 83214) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI DO00768) |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2019-07-26 |