| NPI | 1457704355 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 125068730) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX U6179) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: TX U6179) | |
| Enumeration Date | 2016-07-15 |
| Last Update Date | 2023-10-27 |