| NPI | 1477555845 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: FL ME173139) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: AZ 32231) |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2026-02-25 |