| NPI | 1891170825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 74405) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI MD16261) |
| Enumeration Date | 2015-07-20 |
| Last Update Date | 2024-11-12 |