| NPI | 1457770471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: MN 71701) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: NC 2021-01221) |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2023-11-01 |