| NPI | 1912153057 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: FL ME102462) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME102462) |
| Enumeration Date | 2008-08-08 |
| Last Update Date | 2015-10-13 |