| NPI | 1144272295 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: FL ME123878) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: SC 20951) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2015-08-20 |