| NPI | 1255397089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME 105557) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35-069762) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: OH 35-069762) | |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: FL ME105557) | |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2016-03-09 |