| NPI | 1689201733 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: RI LP05028) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 58954) |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2024-09-05 |