| NPI | 1467125039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: RI MD19717) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT222452) |
| Enumeration Date | 2021-07-29 |
| Last Update Date | 2024-04-22 |