| NPI | 1881874584 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: FL ME114239) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: GA 64653) |
| Enumeration Date | 2007-11-09 |
| Last Update Date | 2013-10-16 |