| NPI | 1245763002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: SC 90585) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.140723) |
| Enumeration Date | 2017-04-09 |
| Last Update Date | 2025-08-19 |