| NPI | 1679558266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: RI MD11198) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: MA 231300) |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2020-04-27 |