| NPI | 1053603670 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: VA 0101252975) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: MI 4301509516) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: UT 13559074-1205) | |
| Enumeration Date | 2011-05-16 |
| Last Update Date | 2023-08-29 |