| NPI | 1982082467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: RI MD16297) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP03430) |
| 207RH0000X Internal Medicine, Hematology (Licence: GA 92558) | |
| Enumeration Date | 2015-05-15 |
| Last Update Date | 2022-08-25 |