| NPI | 1316984636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: RI MD05953) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 50883) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2012-10-04 |