| NPI | 1245645035 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: RI MD16250) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.064331) |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2018-05-31 |