| NPI | 1033550157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 266525) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP02922) |
| Enumeration Date | 2013-07-17 |
| Last Update Date | 2021-03-08 |