| NPI | 1316925464 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC 38919) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI MD10952) |
| Enumeration Date | 2006-01-08 |
| Last Update Date | 2016-02-18 |