| NPI | 1730344128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: RI MD13707) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 242475) |
| Enumeration Date | 2008-07-24 |
| Last Update Date | 2011-08-16 |