| NPI | 1336199975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301073402) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SD 10097) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: MI 4301073402) | |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2023-05-03 |