| NPI | 1497167225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 292793) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI MD15838) |
| Enumeration Date | 2014-05-28 |
| Last Update Date | 2025-02-18 |