| NPI | 1164658019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: HI MD-18023) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: MO 2013015515) |
| 207R00000X Internal Medicine (Licence: GA 073163) | |
| Enumeration Date | 2009-06-05 |
| Last Update Date | 2026-03-19 |