| NPI | 1184165318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: NE 32495) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: VA 0101284347) |
| 207R00000X Internal Medicine (Licence: VA 0101284347) | |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2026-07-21 |