| NPI | 1063873024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: VA 0102204955) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0102204955) |
| Enumeration Date | 2016-03-17 |
| Last Update Date | 2023-07-24 |