| NPI | 1720409519 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: RI DO01263) |
| Additional Taxonomies | 207RB0002X Internal Medicine, Bariatric Medicine (Licence: RI DO01263) |
| Enumeration Date | 2013-12-20 |
| Last Update Date | 2023-12-15 |