| NPI | 1841296670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: FL ME0063353) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: FL ME0063353) |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2022-06-01 |