| NPI | 1518120005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: FL ME 111876) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: NM MD2010-0296) |
| 207R00000X Internal Medicine (Licence: FL ME111876) | |
| Enumeration Date | 2008-07-06 |
| Last Update Date | 2022-02-24 |