| NPI | 1871598904 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: FL ME133280) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 207780) |
| 207R00000X Internal Medicine (Licence: VA 0101237502) | |
| Enumeration Date | 2005-06-15 |
| Last Update Date | 2018-11-13 |