| NPI | 1093219818 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: RI DO01125) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ME DO3215) |
| Enumeration Date | 2018-03-19 |
| Last Update Date | 2023-09-07 |