| NPI | 1275590879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0102049935) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI DO00288) |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2026-07-16 |