| NPI | 1457897514 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: PR 19541) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 19541) |
| Enumeration Date | 2017-01-13 |
| Last Update Date | 2024-10-31 |