| NPI | 1992291215 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 81246) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP04445) |
| 207R00000X Internal Medicine (Licence: IL 036154955) | |
| Enumeration Date | 2018-07-10 |
| Last Update Date | 2023-09-29 |