| NPI | 1225477896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 1021800) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI MD15495) |
| Enumeration Date | 2013-06-17 |
| Last Update Date | 2026-06-12 |