| NPI | 1013975366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: FL ME122301) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: NJ 25MA07398100) |
| 207Q00000X Family Medicine (Licence: MD D0059223) | |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: MD D0059223) | |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2026-05-12 |