| NPI | 1669784450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: FL ME128695) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 244719) |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2016-08-23 |