| NPI | 1831552538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL DO.2104) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL UO5109) |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2020-02-04 |