| NPI | 1639104508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: WV 32136) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 38888) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: KY 38888) | |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2023-04-18 |