| NPI | 1205853215 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: MI 4301078586) |
| Additional Taxonomies | 174400000X Specialist (Licence: MI 4301078586) |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2023-03-01 |