| NPI | 1629041074 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: TX U1976) | 
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: RI MD13901) | 
| Enumeration Date | 2006-02-08 | 
| Last Update Date | 2023-06-23 |