| NPI | 1134145618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: FL ME0094948) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME 94948) |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2021-08-17 |