| NPI | 1184061400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: WA MD61164933) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD61164933) |
| Enumeration Date | 2013-05-28 |
| Last Update Date | 2022-06-21 |