| NPI | 1467984369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: FL OS15955) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL OS15955) |
| Enumeration Date | 2017-03-30 |
| Last Update Date | 2022-07-28 |