| NPI | 1003853268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: RI MD09837) |
| Additional Taxonomies | 207RA0000X Internal Medicine, Adolescent Medicine (Licence: RI RI9837) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2017-02-10 |