| NPI | 1487093373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: VA 0101280316) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT-205263) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: CA A155129) | |
| Enumeration Date | 2013-06-24 |
| Last Update Date | 2024-01-24 |