NPI | 1205498482 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: RI MD19145) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: RI LP04724) |
207QG0300X Family Medicine, Geriatric Medicine (Licence: RI MD19145) | |
Enumeration Date | 2019-07-08 |
Last Update Date | 2023-04-07 |