| NPI | 1578042032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 125072917) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: KY 58756) |
| Enumeration Date | 2018-08-07 |
| Last Update Date | 2024-07-19 |