| NPI | 1154307536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: IA MD-28783) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: IA 28783) |
| 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: IA 28783) | |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2020-11-11 |