| NPI | 1003820721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: LA 025130) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: GA 69410) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2024-05-07 |