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 |