| NPI | 1477501237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: FL ME89905) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: IA 34755) |
| 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: IA 34755) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2026-06-30 |