| NPI | 1487630604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: PA MD465450) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: FL ME76555) |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2022-08-30 |