| NPI | 1649289059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: FL ME95964) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME95964) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2011-07-07 |