| NPI | 1689293656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: RI DO01279) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MA 1020037) |
| Enumeration Date | 2020-04-10 |
| Last Update Date | 2025-01-22 |