| NPI | 1265616858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: TX Q1250) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.009218) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: LA MD.202047) | |
| Enumeration Date | 2007-12-19 |
| Last Update Date | 2024-09-05 |