| NPI | 1194165977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine Infectious Disease (Licence: SD 11802) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5315074350) |
| 207R00000X Internal Medicine (Licence: OH 35132976) | |
| 207R00000X Internal Medicine (Licence: MI 4301103010) | |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2023-06-06 |