| NPI | 1053438945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: GA 111418) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: PA MD448730) |
| 207R00000X Internal Medicine (Licence: GA 111418) | |
| 207R00000X Internal Medicine (Licence: PA MD448730) | |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2026-03-30 |