| NPI | 1588601330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA md.207277) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI MD10616) |
| 207RA0000X Internal Medicine, Adolescent Medicine (Licence: RI RI 10616) | |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2020-04-07 |