| NPI | 1518322163 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: TX U5763) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 312768) |
| Enumeration Date | 2015-12-28 |
| Last Update Date | 2023-08-24 |