| NPI | 1174771323 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 277549) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI MD13459) |
| 207R00000X Internal Medicine (Licence: MA 246004) | |
| Enumeration Date | 2008-08-29 |
| Last Update Date | 2024-11-20 |