| NPI | 1790080133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: FL ME109298) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 22064) |
| 207R00000X Internal Medicine (Licence: FL ME109298) | |
| 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: FL ME109298) | |
| Enumeration Date | 2011-01-16 |
| Last Update Date | 2023-02-02 |