| NPI | 1427499615 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 84696) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 265870) |
| 207R00000X Internal Medicine (Licence: RI LP02885) | |
| Enumeration Date | 2013-07-16 |
| Last Update Date | 2025-09-04 |