| NPI | 1790915916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: FL ME143035) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 18744) |
| Enumeration Date | 2009-07-22 |
| Last Update Date | 2020-04-23 |