| NPI | 1104060904 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: TX R5933) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX R5933) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: NE 25101) | |
| Enumeration Date | 2009-04-23 |
| Last Update Date | 2022-10-20 |