| NPI | 1073747291 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: NY 312764) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD60077190) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: WA MD60077190) | |
| Enumeration Date | 2009-05-04 |
| Last Update Date | 2022-03-09 |