| NPI | 1013907831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: TX P2264) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: MI 4301062322) |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2020-11-19 |