| NPI | 1629507611 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: CO DR.0068164) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX R9828) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: UT 11741890-1205) | |
| Enumeration Date | 2017-06-05 |
| Last Update Date | 2022-08-05 |