| NPI | 1912978545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: FL ME0070416) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME0070416) |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2015-04-06 |