| NPI | 1194793166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: FL ME140622) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: PR 13107) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: FL ACN1019) | |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2019-10-11 |