| NPI | 1821674953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: FL ME152367) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: LA 325973) |
| Enumeration Date | 2021-03-19 |
| Last Update Date | 2021-11-09 |