| NPI | 1962659193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: RI MD13591) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 250312) |
| Enumeration Date | 2008-08-19 |
| Last Update Date | 2025-03-11 |