| NPI | 1184402455 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: TX U8366) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: NY 324444) |
| Enumeration Date | 2023-09-18 |
| Last Update Date | 2024-03-04 |