| NPI | 1336143361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: UT 351005-1205) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: TN MD 37898) |
| 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: UT 351005-1205) | |
| 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: TN MD0000037898) | |
| Enumeration Date | 2005-06-08 |
| Last Update Date | 2022-10-10 |