| NPI | 1235651332 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: RI MD16963) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 1025756) |
| Enumeration Date | 2017-07-10 |
| Last Update Date | 2026-07-07 |