| NPI | 1508358060 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: RI MD17799)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI MD17799)  | 
| 207R00000X Internal Medicine (Licence: MA 275769)  | |
| Enumeration Date | 2018-05-31 | 
| Last Update Date | 2023-01-06 |