| NPI | 1235513672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: AL 42133) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301108363) |
| Enumeration Date | 2015-07-15 |
| Last Update Date | 2024-01-29 |