| NPI | 1205464096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX V9704) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: CO DR.0071407) |
| Enumeration Date | 2020-03-29 |
| Last Update Date | 2025-10-06 |