| NPI | 1154828937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: FL ME161601) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 21478) |
| Enumeration Date | 2018-04-09 |
| Last Update Date | 2024-05-03 |