| NPI | 1356547426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR.0052686) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP01265) |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2014-05-27 |