| NPI | 1629277454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 243137) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 046709) |
| 207R00000X Internal Medicine (Licence: RI MD16969) | |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2023-08-08 |