| NPI | 1811021769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine Infectious Disease (Licence: FL ME 91511) |
| Additional Taxonomies | 207RI0200X Internal Medicine Infectious Disease (Licence: NC 2005-00638) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2022-06-02 |