| NPI | 1508098286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: FL ME118210) |
| Additional Taxonomies | 174400000X Specialist (Licence: OR MD190234) |
| Enumeration Date | 2009-08-14 |
| Last Update Date | 2023-03-07 |