| NPI | 1215987359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: TX M3837) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: WI 48536-020) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2023-06-16 |