| NPI | 1346478534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 1021624) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI MD13853) |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2025-03-19 |