| NPI | 1609023837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101253641) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP01414) |
| Enumeration Date | 2008-08-19 |
| Last Update Date | 2013-09-26 |