| NPI | 1023271475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: RI LAJ00004) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: RI LP001411) |
| 207Q00000X Family Medicine (Licence: RI MD13465) | |
| 207Q00000X Family Medicine (Licence: WI 57281) | |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2017-07-24 |