| NPI | 1609866714 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: FL ME158757) | 
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: TX S8832) | 
| 207R00000X Internal Medicine (Licence: FL ME158757) | |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: GA 052271) | |
| Enumeration Date | 2005-10-28 | 
| Last Update Date | 2025-01-24 |