| NPI | 1669747010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL DO.1410) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN DO2555) |
| Enumeration Date | 2012-03-19 |
| Last Update Date | 2020-06-10 |