| NPI | 1366451338 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 160595) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI DO00506) |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2010-03-08 |