| NPI | 1467039156 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: SC 92559) |
| Additional Taxonomies | 208D00000X General Practice (Licence: GA 94937) |
| Enumeration Date | 2021-03-27 |
| Last Update Date | 2026-06-01 |