| NPI | 1649404013 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME126359) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 261370) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: MA 261370) | |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: FL ME126359) | |
| Enumeration Date | 2009-05-13 |
| Last Update Date | 2021-09-14 |