| NPI | 1508432592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: RI LP05291) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI CLP05291) |
| Enumeration Date | 2021-06-01 |
| Last Update Date | 2021-06-03 |