| NPI | 1003369042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: RI MD16555) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 1021835) |
| Enumeration Date | 2016-07-26 |
| Last Update Date | 2026-06-22 |