| NPI | 1427048446 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101246662) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI MD11584) |
| 207R00000X Internal Medicine (Licence: NC 2008-00696) | |
| Enumeration Date | 2005-10-21 |
| Last Update Date | 2012-07-13 |