| NPI | 1588720783 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: ID M-16906)  | 
| Additional Taxonomies | 174400000X Specialist (Licence: UT 184097-1205)  | 
| 207RI0200X Internal Medicine, Infectious Disease (Licence: MA 249742)  | |
| Enumeration Date | 2006-12-29 | 
| Last Update Date | 2023-01-20 |