| NPI | 1831612035 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: RI MD16997) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: RI MD16997) |
| Enumeration Date | 2017-07-19 |
| Last Update Date | 2025-05-28 |