| NPI | 1063824779 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: VA 0101280399) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: RI MD15687) |
| Enumeration Date | 2014-05-29 |
| Last Update Date | 2024-01-15 |