| NPI | 1619405149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: TX U9227) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX U9227) |
| 207R00000X Internal Medicine (Licence: PA MD480963) | |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: PA MD480963) | |
| Enumeration Date | 2017-05-29 |
| Last Update Date | 2025-10-01 |