| NPI | 1326048208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: FL 6022210) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL me86282) |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2024-06-25 |