| NPI | 1104899160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: CA G71875) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G71875) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: CT 038893) | |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2025-04-18 |