| NPI | 1114313012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: TX V7861) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.026988) |
| 207R00000X Internal Medicine (Licence: OH 35132869) | |
| Enumeration Date | 2015-04-08 |
| Last Update Date | 2025-07-11 |