| NPI | 1154053023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: RI LP05714) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: RI MD21204) |
| Enumeration Date | 2022-06-28 |
| Last Update Date | 2026-04-17 |