| NPI | 1023011962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine Infectious Disease (Licence: VA 0101-029045) |
| Additional Taxonomies | 207RI0200X Internal Medicine Infectious Disease (Licence: NC 98-01050) |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2021-08-16 |