| NPI | 1053676858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: VA 0101259856) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: NE 27208) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: MA 260942) | |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: CT 52994) | |
| Enumeration Date | 2012-07-08 |
| Last Update Date | 2024-12-12 |