| NPI | 1841578242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: FL ME147533) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: MS 24097) |
| Enumeration Date | 2011-08-02 |
| Last Update Date | 2021-03-30 |