| NPI | 1538541560 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: RI MD16245) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 264313) |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2018-06-02 |