| NPI | 1336596709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: RI DO01103) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 288512) |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2025-04-29 |