| NPI | 1023389251 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: TX P6570) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD446342) |
| 207R00000X Internal Medicine (Licence: PA MD446342) | |
| Enumeration Date | 2012-01-19 |
| Last Update Date | 2025-01-31 |