| NPI | 1104165034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: VA 0102203897) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0102203897) |
| Enumeration Date | 2013-02-13 |
| Last Update Date | 2023-08-14 |