| NPI | 1629375688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: PA OT013100) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OT013100) |
| Enumeration Date | 2011-02-27 |
| Last Update Date | 2020-09-30 |