| NPI | 1063876423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: RI DO01273) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: PA OS020645) |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2023-11-30 |