| NPI | 1760476667 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: NH 8392) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: ME 016418) |
| 208000000X Pediatrics (Licence: NH 8392) | |
| Enumeration Date | 2005-09-07 |
| Last Update Date | 2022-09-06 |