| NPI | 1992144281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: PR 21137) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PR 21137) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: FL ME164076) | |
| 208D00000X General Practice (Licence: PR 21137) | |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2024-05-06 |