| NPI | 1134560071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: FL ME151434) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: PA MD463193) |
| Enumeration Date | 2013-07-08 |
| Last Update Date | 2021-11-10 |