| NPI | 1972863629 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: FL ME147092) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: GA 075291) |
| Enumeration Date | 2012-05-29 |
| Last Update Date | 2020-11-18 |