| NPI | 1336165844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 223185) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI MD11642) |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2017-01-02 |