| NPI | 1215372578 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: TN 3069) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0102204541) |
| 207R00000X Internal Medicine (Licence: TN 3069) | |
| Enumeration Date | 2013-04-30 |
| Last Update Date | 2024-01-18 |