| NPI | 1407804792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: FL ME45380) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: OH 35C.001654) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: WI 4096) | |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2024-09-13 |