| NPI | 1255783528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: FL ME139829) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: MN 64230) |
| Enumeration Date | 2016-07-11 |
| Last Update Date | 2020-01-27 |