| NPI | 1063734069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: WI 65452-20) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME105163) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: IN 01087532A) | |
| Enumeration Date | 2010-02-18 |
| Last Update Date | 2024-04-30 |