| NPI | 1306231436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA 308659) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL DO.1671) |
| Enumeration Date | 2015-04-06 |
| Last Update Date | 2018-11-28 |