| NPI | 1619243235 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: MI 4301502546) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301100898) | 
| Enumeration Date | 2012-03-28 | 
| Last Update Date | 2020-04-24 |