| NPI | 1881851483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA DO.000200) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 2541) |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2022-08-12 |