| NPI | 1467972182 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: RI MD16937) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 1013444) |
| Enumeration Date | 2017-06-23 |
| Last Update Date | 2026-06-22 |