| NPI | 1124481486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: MA 284167) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: MA 275850) |
| Enumeration Date | 2016-04-03 |
| Last Update Date | 2021-07-27 |