| NPI | 1639706609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: MN 76830) |
| Additional Taxonomies | 208D00000X General Practice (Licence: ZZ 1018447561) |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2024-10-21 |