| NPI | 1356569826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: RI MD19043) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 254567) |
| 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: RI LP00767) | |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2025-04-01 |