| NPI | 1891275566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: RI MD17506) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP04366) |
| Enumeration Date | 2018-08-21 |
| Last Update Date | 2023-02-17 |