| NPI | 1164719357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: IL 125.064371) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2011015465) |
| Enumeration Date | 2011-07-07 |
| Last Update Date | 2022-07-21 |