| NPI | 1831110535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: FL ME40632) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: FL 0040632) |
| 174400000X Specialist (Licence: FL ME40632) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2023-11-29 |