| NPI | 1366606394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: MS 26741) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101247658) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: VA 0101247658) | |
| Enumeration Date | 2008-07-18 |
| Last Update Date | 2020-01-16 |